23D2042389 CLIA NUMBER - WALGREENS #15466

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Laboratory Demographics

CLIA Number: 23D2042389

Facility Name: WALGREENS #15466

Facility Address:
800 LEONARD STREET NW
GRAND RAPIDS, MI
ZIP 49504
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Facility Phone Number: 616 458-8300

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1265447379

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	23D2042389
LAB Type	Pharmacy
Facility Name	WALGREENS #15466
Street	800 LEONARD STREET NW
City	GRAND RAPIDS
State	MI
ZIP	49504
Phone	616 458-8300
CertificateType	4
CertificateEffectiveDate	4/5/2023
CertificateExpirationDate	4/4/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024